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1987年12月中旬至1988年1月中旬,唐山市某学院学生中发生军团病流行,现将我们收治的2例嗜肺军团菌肺炎报告如下: 例1 男,19岁,学生。病前其宿舍一同学因持续高热、寒战4天,咯血1天,在某医院诊为“中毒型肺炎”,曾用青、链霉素及各种抗休克治疗,但病情进行性恶化死亡。本例患者一直参加看护,事后第二天无明显诱因自觉畏寒、发热、头痛、干咳、胸痛,体温达38℃以上,自述与死亡同学病初症状相似,收入病房。体温38℃,脉搏100次/分,呼吸24次/分,血压13.3/9.3kpa(100/70mmHg)。神志清,急性病容。皮肤粘膜未见异常,浅表淋巴结未触及。结膜及咽部轻度充血,扁桃体不肿大。胸、腹、四肢、神经系统检查无阳性所见。胸正位X线片示右上肺外带2、3前肋间片状密度较高,边缘不清阴影。实验室检查:白细饱4.2×10~9/L,分类中性分叶核44%,淋巴细胞56%。
From mid-December 1987 to mid-January 1988, there was a prevalence of Legionnaires’ disease in a college student in Tangshan City. We now report the following 2 cases of Legionella pneumophila pneumonia we treated: Example 1 Male, 19 years old, student. Pre-sick quarters a classmate for sustained high fever, chills 4 days, 1 day hemoptysis, a hospital diagnosed as “poisoning pneumonia”, who used blue, streptomycin and various anti-shock treatment, but the disease progressive deterioration of death. The patient has been attending nursing, after the second day no obvious incentive for a sense of chills, fever, headache, dry cough, chest pain, body temperature of 38 ℃ or more, readme and death of students with early symptoms similar to income wards. Body temperature 38 ℃, pulse 100 beats / min, breathing 24 beats / min, blood pressure 13.3 / 9.3kpa (100 / 70mmHg). Conscious, acute illness. No abnormal skin and mucous membranes, superficial lymph nodes not touched. Conjunctival and pharyngeal mild hyperemia, tonsil does not enlarge. Chest, abdomen, limbs, neurological examination found no positive. X-ray chest X-ray showed the right upper lung take 2,3 before the intercostal flake higher density, unclear shadow edge. Laboratory tests: white fine 4.2 × 10 ~ 9 / L, classification of neutral leaf core 44%, lymphocytes 56%.